| NPI | 1881638013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NC 200300349) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 119015) |
| 207V00000X Obstetrics & Gynecology (Licence: KY 02241) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2018-03-17 |